Their interpretation of the recent ER wait study:
The researchers attribute the longer waits primarily to an increase in the number of emergency room visits coupled with the closure of many emergency rooms. Both factors are driven by the lack of universal health coverage. Uninsured patients “” and those who have no primary care doctor “” flock to emergency rooms for routine coverage, clogging the system. Meanwhile, hospitals lose so much money dispensing charity care through emergency rooms that many collapse into bankruptcy or give up emergency care.
Wrong on the first count. Studies have debunked the myth of the uninsured flooding emergency rooms, when in fact, people with private insurance accounted for most of the growth in emergency-room crowding.
I agree with the second point. There are not enough primary care physicians. Simply mandating universal coverage without a corresponding increase in primary care support will further crowd the ER.
Update:
David Catron with a roundup of blogosphere opinion.
Related posts:
- Many uninsured choose to stay that way
- ER visits and health care costs rise in Massachusetts due to lack of primary care access
- Can universal health coverage be sustained long-term?
- My take: Diagnosis, Big Dig, ED waits
- More coverage requires more doctors, my take in The New York Times
- Why EDs are overcrowded
- NY Times hearts Massachusetts
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Emergency Department (ED) wait times as you say Kevin are not because EDs are being flooded with uninsured people. I’d like to see the data that supports this conclusion. EDs are over crowded for a number of reasons. Fist as you pointed out there are not enough primary care providers in the system, and it takes an incredibly long time for many patients to get an appointment to see their own physician/NP etc.
Out of convenience many people go to the ED because despite the wait it is still faster than their PCP.
Other factors that contribute to ED crowding/wait times as the article points out is the admissions process at a hospital. Some institutions do very well with patient flow, others do not. Often times there is a bed crunch going on and the hospital is full. It backs up the system.
Insurance or the lack there of is unlikely to impact ED waiting times. It is a supply and demand issue. EDs and hospitals have finite resources. When these resources are stressed than the system will respond accordingly.
Thanks for the opportunity.
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